In this study, investigators aimed to transplant autologous, adipose tissue derived
mesenchymal stem cells to the patients with liver cirrhosis. Investigators also aimed to
assess liver tissue regeneration, downgrade of clinical findings and antiviral efficacy.
Finally investigators aimed to establish an alternative treatment modality to liver
transplantation.
Hepatitis C Virus (HCV) which can lead to chronic hepatitis, liver cirrhosis and
hepatocellular carcinoma (HCC) is an important health problem especially in western
countries. In 5% - 25 of patients with chronic HCV hepatitis who are nonresponders to current
medical treatment, liver cirrhosis develops. Approximately 1/3 of patients with liver
cirrhosis become decompensate in 10 years. Medical treatment of liver cirrhosis, the last
stage of the illness that leads to morbidity and mortality is difficult. Liver
transplantation is still the most effective treatment for the patients with liver cirrhosis
due to chronic hepatitis C, However, serious problems are accompanied with liver
transplantation. Lack of liver donors, complications during and after the surgery, graft
rejection and high costs are the main problems.
There are cells in the human body that are capable to renew themselves and differentiate to a
diverse range of specialized cell types. These are called "stem cells". Stem cells can be
differentiated to specialized cells in appropriate medias in the laboratory. Recently, the
differentiation potential of mesenchymal stem cells (MSCs) into hepatocytes is proved by
demonstrating hepatocytes containing Y chromosome in the female who has had bone marrow
transplantation from male donors. In many laboratory studies, it is observed that human
adipose tissue derived mesenchymal stem cells, transplanted to animals with induced liver
damage, differentiate into the albumin producing hepatocytes. Even though the number of
studies on human for the same purpose is few, findings are supporting those of animal
experiments. Some very recent studies emphasize the antiviral effects of MSCs. The reasons
for choosing this study title is; no available medical treatment for the non-responder
cirrhotic patients, shortage of organ donors, patients rapidly progressing to transplantation
candidates, and patients dying while they are in waiting lists and finally hopeful data
regarding MSC applications. This is a hopeful, avant garde and sophisticated study which may
constitute new horizons in context of cellular therapies.
In this study autologous adipose tissue derived MSCs will be transplanted to patients with
liver cirrhosis due to chronic hepatitis C. After invitro expansion, patients will receive 1
million cells per kg. via peripheral vein every week for 3 times. Also via hepatic artery, 3
million cells per kg will be infused for 3 times in every 2 weeks. With this protocol,
investigators aimed to increase liver regeneration, decrease in liver fibrosis, increase the
waiting time of patients in transplantation lists and finally to establish a new and
regenerative treatment protocol alternative to liver transplantation. For observation of
clinical and laboratory improvement, patients are planned to be monitored by pathology
examination of liver biopsies before and at 6th month after the treatment, monthly
biochemical and hematologic blood tests and periodic radiologic examinations.